Clinic Forms

Keep an eye on this page for appropriate forms necessary for clinic appointments.

Pediatric - Speech
If your child has a Speech-Language Evaluation Appointment, please click here to download the Pediatric Intake form. It should be filled out and faxed to: 212 481 3029 at least 3 business days prior to your appointment. You may also scan and email the form to hcccd@hunter.cuny.edu.

Adult - Speech
Please click here to download the Adult intake form. It should be filled out and faxed to: 212 481 3029 at least 3 business days prior to your appointment. You may also scan and email the form to hcccd@hunter.cuny.edu.

Pediatric - Audiology
For youngsters having an audiological evaluation, please download this Pediatric Audiology History form, complete it and bring to your appointment. It can also be faxed to 212 481 3029. You may also scan and email the form to hcccd@hunter.cuny.edu.

Adult - Audiology
Please click here to download the Adult intake form. It should be filled out and faxed to: 212 481 3029 at least 3 business days prior to your appointment. You may also scan and email the form to hcccd@hunter.cuny.edu.